Objective: The purpose was to develop a new nursing unit designed for the needs of the geriatric psychiatric patient. Frequently located in a pre-existing nursing unit, these patients are forced to adapt to a restrictive format. Important to this population are safety and security; a feeling of well being; and the accommodation of impaired visibility, mobility and judgement.
Design: A Facility Evaluation of the existing space and operation was performed to identify deficiencies.
Materials and Methods: 1. a search of applicable literature and studies previously done on the effects of environment on geriatric and psychiatric patients 2. caregivers and staff were interviewed to understand patient behavior 3. observation of the existing unit and its operation 4. photographs, measurements, and documentation of existing conditions 5. mock-up environments were evaluated
Results: The following design solutions were implemented: The hallways have continuous handrails to encourage walking and movement. The flooring is not shiny so that the patients do not think it is slippery. There are no abrupt changes in flooring surfaces, which can startle and intimidate patients. Indirect lighting reduces glare, and the wall sconces and artwork provide interest and entertainment.
A quilt theme used throughout evokes a feeling of comfort and familiarity.
A comfortable sitting area in the hallway encourages socialization, as does the furniture groupings in the Therapy Rooms.
The seating selected provides a variety of choices. Recliners, gliders, loveseats and dining chairs at tables all provide good support and have arms for ease of getting in and out. The upholstery is woven Crypton textile, which is warm in look and feel but is impervious to liquids and easy to clean. Some chairs can be used to transport patients. The rockers are calming and therapeutic.
Strong contrast between the floor and wall planes helps orient the patient. Abrupt changes in color or pattern on the floor can be misunderstood due to impaired depth perception, therefore no patterning was used.
Necessary changes in flooring materials are smooth to accommodate wheeled items, shuffling feet and walking aids.
A green and rust color scheme was selected due to their higher visibility to the aging eye. Wood trim adds warmth.
Safety precautions were paramount and items such as breakaway curtains and tamper-proof electrical devices were utilized.
Patient Toilet Rooms have integral cove base and solid surface counters and sinks for ease of cleaning. The walls contrast in color to the floor, as does the leading edge of the sink, for greater visibility. Patient toilets are visible from the bed to encourage hygienic habits.
Conclusion: Environmental elements can be used to positively affect the behavior of geriatric psychiatric patients.
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